| Doctor Name: | MS. TERRA J GRANDMASON |
| NPI Number: | 1235328501 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | AP30007907 |
| Business Practice Address: | 575 E. Main Street Elma, WA - 985419551 |
| Business Phone Number: | 3604823711 |
| Business Fax Number: | 3608618675 |
| Mailing Address: | 600 E. Main Street, ELMA |
| State: | WA |
| Postal Code: | 98541 |
| Phone Number: | 3604823711 |
| Fax Number: | 3608618675 |
| NPI Enumeration Date: | 10/23/2007 |
| NPI Last Update Date: | 01/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP30007907 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |